Published in:
01-04-2007 | Original Article
Experiences With and Attitudes Toward Death and Dying Among Homeless Persons
Authors:
John Song, MD, MPH, MAT, Edward R Ratner, MD, Dianne M. Bartels, RN, MA, PhD, Lucy Alderton, MPH, Brenda Hudson, MS, Jasjit S. Ahluwalia, MD, MPH, MS
Published in:
Journal of General Internal Medicine
|
Issue 4/2007
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Background
Homeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect. Few studies have explored their experiences and attitudes toward death and dying. Unfortunately, studies done in other populations may not apply to homeless persons. Exploring these experiences and attitudes may provide insight into life, health care, and end-of-life (EOL) concerns of this population.
Objective
To explore the experiences and attitudes toward death and dying among homeless persons.
Design
Qualitative study utilizing focus groups.
Participants
Fifty-three homeless persons recruited from homeless service agencies.
Measurements
In-depth interviews, which were audiotaped and transcribed.
Results
We present seven themes, some of which are previously unreported. Homeless persons described many significant experiences with death and dying, and many participants suffered losses while very young. These encounters influenced participants’ attitudes toward risks and risky behavior: e.g., for some, these experiences provided justification for high-risk behaviors and influenced their behaviors while living on the streets. For others, they may be associated with their homelessness. Finally, these experiences informed their attitudes toward death and dying as well as EOL care; homeless persons believe that care will be poor at the EOL.
Conclusions
Findings from this study have implications for addressing social services, health promotion, prevention, and EOL care for homeless persons, as well as for others who are poor and disenfranchised.